Safety is always the top priority for the HTM professional working in today’s healthcare environment. With this in mind one should probably think about the changes in how the delivery of healthcare today is taking place and where will it be administered in the future. As we are all aware we are seeing many more clinics and standalone surgical centers for more minor procedures.
I attended yesterday a really good presentation by Dr. Tejal Gandi on The Changing Landscape of Patient Safety. I believe I will take her advice as she is the President and CEO of the National Patient Safety Foundations and seems to be pretty well educated. With a degree in biochemistry from Cornell, some extra training at Duke University and her MD and MPH from Harvard School of Medicine and is currently an Associate Professor of Medicine at Harvard Medical School.
This seminar did not focus on the normal issues you may think of when dealing with patient safety such as leakage or touch current etc. but in home health or ambulatory setting. Dr. Ghandhi explained some of her research which shows many patients are not receiving adequate safe care for different reasons.
Dr. Gandhi explained the areas which must be addressed for this patient population to show better health outcomes. These areas are: Patient Engagement, Safety across care continuum and healthcare information technology. Some of the problems her research shows is with ambulatory patients the feedback loop for information to the healthcare provider is too long, so issues such as adverse drug events take too long to address. She did say that e-prescriptions is a way to help in the areas of adverse drug interactions however with this patient population only about 75% of prescribed prescriptions are being filled because of drug cost concerns from the patients. This patient population is also experiencing missed or delayed diagnosis of problems. She highlighted this area as it is a TJC requirement to be able to document and show medication reconciliation as part of the outpatient safety infrastructure.
I was surprised when one of the areas her research showed was there seems to be poor patient engagement with healthcare personnel. Research showed that the better the patient engagement, which should involve other family members also had better outcomes and better patient safety results. She recommended that patient / family engagement in home healthcare should be in the facilities “core” competencies.
Her findings also indicated through her research there must be a cultural shift in the workforce. Basically she explained how workforce safety translates into patient safety. She mentioned how stressed caregivers are with their work volume and this leads to mistakes and degrades patient safety. She shared several interesting facts to support her claim. 33% of nurses acquire a back injury every year and that healthcare workers are thirty times more likely to be injured on the job than any other industry and I must say I was shocked by these numbers. Another cultural shift in the work environment has to deal with workers feeling appreciated for their work. As Dr. Gandhi stated, when healthcare workers feel unappreciated and over worked this produces patient errors. Hospitals that have initiated programs that show all employees more dignity, respect etc. from the physician to the environmental staff workers, research is confirming patient errors go down.
One healthcare facility she studied after administering a human resources program of the 3 R’s. Each employee of the healthcare facility must have the “RESOURCES” to perform their job, must have “RESPECT” from other workers and must have “REGOGNITION” for a job well done. When these 3 R’s were employed adverse events in patient safety fell by 56% which I think we can all agree is quite significant. With being a topic at AAMI, this information could find it’s way onto an exam in the near future. – OK, off to another training session! JN